tbuckley/cabot-search huggingface dataset:
Abstract 52: Using Smartphone-Based Digital Phenotyping to Understand Lifestyle and Behavioral Risks of Cardiometabolic Diseases: The Beiwe Smartphone Sub-Study of Nurses’ Health Study 3 and Growing Up Today Study
Authors: LI YI, Jaime E Hart, Grete Wilt, Cindy Hu, Francine Laden, Jorge Chavarro, Peter James
Journal: Circulation (2023)

Background: Emerging evidence has suggested lifestyle and behavioral factors such as physical activity, diet, and sleep may be associated with cardiometabolic health outcomes in US adults. However, these studies typically have limited temporal or spatial coverage. The current study aimed to fill in this gap by applying smartphone-based digital phenotyping to collect dynamic, high temporal resolution measures of lifestyle and behavioral factors. Methods: Participants (N = 2,127 as of Sep 7 th , 2022) of the Beiwe Smartphone Sub-study of Nurses’ Health Study 3 (NHS3) and Growing Up Today Study (GUTS) completed microsurveys delivered by the Beiwe smartphone application for a year each. Starting July 2021, a microsurvey was delivered every 10 days, covering one of the 12 different topics, including emotions, stress, physical activity, green space, pets, diet, sleep, and sitting. These questionnaires aimed to measure various aspects of participants’ key health behaviors, to combine with objectively assessed high-resolution GPS and accelerometer data that participants provided during the same period. Results: Between July 28 th , 2021, and Sep 7 th , 2022, 2,127 participants completed 22,039 microsurveys delivered by the Beiwe application. The mean follow-up for participants was 116 days (SD=124, range=221). During this period, each participant on average submitted 10 microsurveys (SD=10, range=39). The topic completed most consistently (N=1,955 responses) was pets (the first microsurvey), and 43.3% of responses from participants reported a park visit in the past week. Additionally, 71.2% of responses from participants reported they spent at least a few minutes walking for exercise in the past week. Furthermore, during the same period, participants on average provided 177 days (SD=123, range=218) of GPS data and 181 days (SD=181, range=224) of accelerometer data. Conclusions: In this study, the smartphone-based digital phenotyping technology was implemented to collect intensive longitudinal data on lifestyle and behavioral factors in two well-established prospective cohorts. The efforts so far have resulted in a rich dataset on health behaviors, which can be linked to locations and future cardiometabolic health outcomes.
Abstract P214: The Portfolio Dietary Pattern and Risk of Cardiovascular Disease in US Adults
Authors: Andrea J Glenn, Marta Guasch, Vasanti Malik, Cyril Kendall, Joann E Manson, Eric B Rimm, Walter Willett, Qi Sun, David Jenkins, John L Sievenpiper, Frank B Hu
Journal: Circulation (2023)

Introduction: The plant-based portfolio dietary pattern includes recognized cholesterol-lowering foods shown to improve several cardiovascular disease (CVD) risk factors in clinical trials. Epidemiological evidence on the association between longer-term adherence to the portfolio dietary pattern and CVD risk remains more limited. Objective: To examine whether the portfolio dietary pattern is associated with the risk of total CVD, coronary heart disease (CHD, including myocardial infarction and fatal coronary deaths), and stroke. Methods: Participants included 73,925 women in the Nurses’ Health Study (NHS) (1984-2014), 92,354 women in the NHS2 (1991-2017) and 43,970 men from the Health Professionals Follow-up Study (HPFS) (1986-2016) without CVD and cancer at baseline. Diet was assessed using validated food frequency questionnaires at baseline and every four years using a portfolio diet score (PDS) which positively ranks plant protein (soy &amp; pulses), nuts, viscous fiber sources, phytosterols (mg/day) and plant monounsaturated fat sources, and negatively ranks foods high in saturated fat and dietary cholesterol. Cox proportional hazards regressions were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs), adjusted for covariates. Results: During up to 30 years of follow-up, 16,917 incident CVD cases, including 10,666 CHD cases and 6,473 stroke cases, were documented. After multivariable adjustment of lifestyle and other dietary factors, comparing the highest to the lowest quintile, participants with a higher PDS had a lower risk of total CVD (pooled HR: 0.84; 95% CI: 0.80-0.89, P trend&lt;0.001), CHD (pooled HR: 0.82; 95% CI: 0.76-0.87, P trend&lt;0.001) and stroke (pooled HR: 0.88; 95% CI: 0.81-0.97, P trend=0.001). In addition, a 25-percentile higher PDS was associated with a lower risk of total CVD (pooled HR: 0.91; 95% CI: 0.88-0.93), CHD (pooled HR: 0.89; 95% CI: 0.86-0.92) and stroke (pooled HR: 0.93; 95% CI: 0.89-0.97). Results remained largely consistent across sensitivity and subgroup analyses. Conclusions: Greater adherence to the portfolio dietary pattern was consistently associated with lower risk of CVD, including CHD and stroke, in three large prospective cohorts of U.S. men and women.
Abstract P468: Time Trends in Severity of Incident Ischemic Stroke in the Atherosclerosis Risk in Communities Study From 1987 to 2018
Authors: Silvia Koton, Jinyu Chen, Michelle C Johansen, James R Pike, Thomas Mosley, Wayne D Rosamond, Andrea Schneider, Rebecca F Gottesman, Josef Coresh
Journal: Circulation (2023)

Background: Stroke severity at hospital admission is the most important clinical predictor of short- and long-term functional outcome and mortality after stroke. Decreases in stroke severity over the last two decades have been reported in some countries; however, data on stroke severity from large prospective cohort studies in the US are not available for recent years. We studied trends in stroke severity of incident ischemic stroke from 1987 to 2018 in the prospective Atherosclerosis Risk in Communities (ARIC) study. Methods: Severity of stroke on admission was determined through review of ARIC hospital charts for incident ischemic strokes using the National Institutes of Health Stroke Scale (NIHSS). Events with inadequate information for NIHSS score determination were excluded (n=209). Severity was categorized as minor, NIHSS≤5; mild, 6-10; moderate, 11-15; and severe, ≥16. Mean NIHSS scores by year were presented by age group (Figure) and trends in NIHSS score from 1987 to 2018 were studied with linear regression model. Changes in the proportion of minor stroke compared to more severe stroke (NIHSS&gt;5) were assessed using logistic regression. Multivariable models included age at stroke, sex, race-center, and baseline education level, hypertension, BMI, diabetes and smoking status as covariates. Results: Among 15,661 participants (age 45-64) free of stroke at baseline (1987-89), 1,036 incident stroke cases with severity scores (NIHSS: 638 [61.6%] minor, 222 [21.4%] mild, 88 [8.5%] moderate and 88 [8.5%] severe) were included. Mean age (SD) at incident stroke was 69.5 (9.9) years, 55.2% women and 26.8% Black. For each 1-year calendar time, the adjusted estimate for the continuous NIHSS score was -0.026 (SE=0.040), p=0.5109, and the adjusted OR (95% CI) for NIHSS≤5 compared to NIHSS&gt;5 was 0.99 (0.97, 1.01). Conclusion: Among participants with incident ischemic stroke in the prospective ARIC study, no clear decrease in severity of stroke was observed from 1987 to 2018.
Abstract 10: Cumulative Ideal Cardiovascular Health During Young Adulthood and Premature Cardiovascular Events in Midlife
Authors: Hokyou Lee, Hyeok-Hee Lee, Eunji Kim, So Mi Jemma Cho, Hyeon Chang Kim
Journal: Circulation (2023)

Introduction: Data are lacking on the association between long-term cumulative achievement of ideal cardiovascular health (CVH) during young adulthood and midlife cardiovascular disease (CVD) events. We hypothesized that higher cumulative ideal CVH score during young adulthood is associated with lower risk of CVD events in midlife. Methods: We studied 230 959 participants of the Korean National Health Insurance health screening at index age 40 years without prior CVD. All participants underwent ≥3 (median, 7) health examinations, including Y0 at age 30, Y10 at age 40, and ≥1 visit in between. We defined a 10-year cumulative CVH score, calculated as the area under CVH score plotted against age from 30 to 40 years, based on the AHA’s “Life’s Simple 7” metric excluding diet (score 0-12 at each visit; cumulative score 0-120 over 10 years; Figure A). The primary outcome was composite CVD events, including myocardial infarction, stroke, heart failure, and CVD-related death. Results: During a median follow-up of 9.6 years after index age 40 years, 2180 CVD events occurred. Participants with higher cumulative CVH score before age 40 years had lower cumulative incidence of CVD events over the next decade (Figure B). After multivariable adjustment, each year lived with 1-point higher CVH score from age 30 to 40 years was associated with 3.5% lower hazard of CVD events after age 40 years (Figure C). Each 1-point higher CVH score maintained for 10 years was associated with 30% lower hazard of CVD events. The associations remained significant even when adjusted for midlife CVH (single-visit CVH score at index age 40 years). When stratified by midlife CVH, higher cumulative CVH score during young adulthood was associated with lower hazard of subsequent CVD events, irrespective of midlife CVH (Figure D). Conclusions: Cumulative attainment of ideal CVH during young adulthood, independently of midlife CVH, was associated with lower risk of premature CVD events in midlife, highlighting the importance of maintaining ideal CVH from an earlier age.
Abstract MP56: Intake of Ultra-Processed Foods is Associated With an Increase in Risk for Type Two Diabetes: Results From Three U.S. Cohort Studies and a Meta-Analysis
Authors: Zhangling Chen, Neha Khandpur, Clemence Desjardins, Carlos Monteiro, Sinara Rossato, Teresa Fung, Joann E Manson, Walter Willett, Eric B Rimm, Frank Hu, Qi Sun, Jean-Philippe Drouin-chartier
Journal: Circulation (2023)

Introduction: There is limited evidence on the association between long-term consumption of ultra-processed foods (UPF) and the risk of type 2 diabetes (T2D), among the U.S population. The overall strength of this association has also not been established. Hypothesis: Higher intake of UPF is associated with a higher risk of T2D in U.S. adults. The pooled risk estimates from published literature reinforce the positive relationship between the UPF intakes and T2D. Methods: We first assessed this relationship among 71,871 women from the Nurses’ Health Study (NHS, 1984-2016), 87,918 women from NHSII (1991-2017), and 38,847 men from the Health Professionals Follow-up Study (HPFS, 1986-2016) who were all free of T2D at baseline. Diet was assessed using food frequency questionnaires, every 2-4 years. UPF were categorized according to the Nova classification. Information on incident cases of T2D was obtained through follow-up questionnaires every 2 years. The association between UPF intake and incident T2D was examined using Cox proportional hazards models. Second, after conducting a systematic review of prospective cohort studies, risk estimates from all included cohorts were pooled in a random-effects, dose-response, meta-analysis to assess nonlinearity of the association between total UPF intake and T2D risk. Finally, the strength of the meta-evidence was assessed using NutriGrade. Results: During 5,187,678 person-years of follow-up across the three cohorts, 19,503 T2D cases were documented. The pooled multivariable-adjusted hazard ratios (HRs) for T2D between the extreme quintiles of total UPF intake (% of grams/day), was 1.36 (95% confidence interval (CI): 1.29, 1.44; P trend &lt;0.0001). This relationship was driven by intakes of ultra-processed animal-based products, ready-to-eat mixed dishes and artificially- and sugar-sweetened beverages. Ultra-processed cereals and ultra-processed dark breads and whole-grain breads were inversely associated with T2D risk. In the meta-analysis (7 risk estimates, 415,554 participants and 21,932 T2D cases), a significant positive dose-response association between total UPF intake and T2D was observed (P=0.90 for non-linearity): a 10% increase in total UPF intake (% grams from UPF/day) was associated with a 10% higher risk of T2D (95%CI: 8%, 12%; I 2 =23.1%; P heterogeneity =0.25). Per NutriGrade, the evidence supporting the positive relationship between total UPF intake and T2D was of high quality. Conclusions: High quality evidence shows that total UPF consumption is associated with higher risk of T2D, although not all individual foods classified as ultra-processed were associated with a higher risk in these U.S. cohorts.
Abstract MP32: Body Weight Variability in Young Adulthood and Echocardiographic Precursors of Heart Failure in Later Life: The Coronary Artery Risk Development in Young Adults (CARDIA) Study
Authors: QUEEN N AGHAJI, Chike C Nwabuo, Duke Appiah, Yano Yuichiro, Anthony J Viera, Norrina B Allen, Jamal S Rana, Donald Lloyd-Jones, Pamela J Schreiner, Joao AC Lima
Journal: Circulation (2023)

Background: The association between variability in body mass index (BMI) in early adulthood and cardiac structure and function in midlife has not been previously examined. Methods: We examined 2371 Coronary Artery Risk Development in Young Adults (CARDIA) participants who had BMI assessments across 25-years (CARDIA exam year 0 [1985-1986], 2 [1987-1989], 5 [1990-1991], 7 [1992-1993], 10 [1995-1996], 15 [2000-2001], 20 [2005-2006], and 25 [2010-2011]) as well as echocardiography data at the year-25 exam (2010-2011). BMI variability was assessed by standard deviation (SD) across 25 years. Adjusted multivariable linear regression models were used to assess the association between echocardiography variables (dependent variable) and SD of BMI (independent variable). Model 1 was adjusted for standard cardiac risk factors (age, sex, race, education, blood pressure, anti-hypertension medication use, smoking, fasting plasma glucose, alcohol consumption, physical activity, HDL and total cholesterol. Model 2 was additionally adjusted for mean BMI. Results: Among participants included in the analysis, mean [SD] age at the year 25 exam [2010-2011] was 50.4 [3.6] years; 44.5% were men; and 41.3% were black). In model 1, greater SD of BMI was associated with greater left ventricular mass (β 5.18g, p&lt;0.001), left ventricular global longitudinal strain 0.08, p=0.01, and left atrial volume (β 1.60ml, p&lt;0.001). Additional adjustment for mean BMI, attenuated associations (p&gt;.05 for all). Greater SD of BMI was associated with worse diastolic function (E/é) (β 0.11, p&lt;0.001). Observed association between BMI variability and E/é persisted even after accounting for mean BMI (β 0.08, p=0.01). Conclusions: Greater body weight variability in young adulthood was associated with modest unfavorable midlife alterations in diastolic function.
Abstract P320: Adverse Childhood Experiences Are Associated With Greater Adiposity in Midlife Women: Findings From the Prospective Project Viva Cohort
Authors: Nicole Bornkamp, Melissa N Sidote, Mingyu Zhang, Amy Nichols, Sheryl L Rifas-Shiman, Marie-France Hivert, Emily Oken
Journal: Circulation (2023)

Introduction: The associations of adverse childhood experiences (ACEs) with adiposity are not well characterized in midlife women, a life stage when cardiometabolic risk increases substantially. Hypothesis: More reported adverse childhood experiences are associated with greater body mass index (BMI) and waist circumference (WC). Methods: At mean (SD) 51.0 (5.0) years, 432 participants in the Project Viva cohort completed questionnaires and research staff measured height and weight (used to derive BMI) and waist circumference. Women self-reported personal history of ACEs (10 possible types in 3 subdomains: abuse, neglect, and household challenges) prior to 18 years old. We used multivariable linear regression to evaluate associations of ACEs with BMI and waist circumference and adjusted for childhood social factors including parental education, US birth, and race/ethnicity. Results: Mean (SD) ACE score was 1.7 (1.9), BMI was 27.4 (6.2) kg/m 2 and WC was 91.8 (15.3) cm. In unadjusted models, each additional ACE was associated with higher BMI (β =0.49kg/m 2 , 95% CI: 0.18, 0.80) and greater waist circumference (β =0.94cm, 95% CI: 0.18, 1.71). Adjusting for childhood social factors reduced associations and 95% CIs included the null (BMI: 0.19kg/m 2 , 95% CI: -0.13, 0.51; WC: 0.35cm, 95% CI: -0.45, 1.14). Associations were stronger for ACEs related to abuse and neglect versus household challenges in unadjusted and adjusted models (Figure). Adjusting for childhood social factors attenuated the associations for neglect and household challenges subdomains, but less so for abuse. Conclusions: Adverse childhood experiences are associated with greater adiposity measures in midlife women. The differing associations of ACEs subdomains with adiposity indicate that these outcomes may be more strongly related to the type of ACE someone experiences than solely the number of ACEs experienced.
Abstract P307: Elevated Blood Pressure Accelerates White Matter Brain Aging in Late Middle-Aged Women: A Mendelian Randomization Study in UK Biobank
Authors: Li Feng, Zhenyao Ye, Shuo Chen, Tianzhou Ma
Journal: Circulation (2023)

Background: Elevated blood pressure (BP) is a modifiable risk factor associated with cognitive impairment and cerebrovascular diseases. However, the causal effect of BP on white matter (WM) brain aging remains unclear. In this study, we hypothesize that increasing BP will accelerate WM brain aging. Methods: In our study, we focused on N=219,968 non-pregnant, family-unrelated individuals of European ancestry who had genotype data and two non-null clinical BP measurements available (99,532 male and 120,436 female, age range: 40-69, 16,901 have neuroimaging data available) collected from UK Biobank (UKBB). In the current study, we adopted a chronological age-adjusted brain age metric, Brain Age Gap (BAG), as the outcome variable to measure the brain aging status. As a first step, we applied machine learning method to establish the model to compute BAG based on fractional anisotropy (FA) measurements derived from structural neuroimaging data among a group of subjects without hypertension (N=7,728). The established model will be applied to calculate WM BAG in other subjects with or without hypertension. We then performed association analysis as well as a two-sample Mendelian Randomization (MR) analysis to estimate the causal effect of BP on WM BAG in the whole population and subgroups stratified by gender and age brackets . In the first sample with genotype and BP data but no WM FA data (N=20,3067), we tested the genetic-exposure association and identified relevant genetic variants as instrumental variables. In the second non-overlapping sample with genotype, BP, and WM FA data, we tested the genetic-outcome association (N=8,822). The causal effect of BP on WM BAG is estimated by using a generalized version of the inverse-variance weighted (IVW) approach. Results: The non-hypertension group and females had younger brains (WM BAG) across all the year cycles than the hypertension group by 0.3098 year and males by 1.2666 years, respectively, both p &lt;0.0001. The association analysis revealed that both Diastolic Blood Pressure (DBP) and Systolic Blood Pressure (SBP) had a stronger significant relationship with WM BAG among females (&amp;#946;SBP=0.0149; &amp;#946;DBP=0.0233), 50-59 aged group (&amp;#946;SBP=0.0163; &amp;#946;DBP=0.0259), and 60-69 aged group (&amp;#946;SBP=0.0086; &amp;#946;DBP=0.0147), all p &lt; 0.0001. The MR analyses showed that DBP had a significant causal effect on WM BAG among females aged 50-59 (&amp;#946;=0.0720, p=0.0243) and females aged 60-69 (&amp;#946;=0.1000, p=0.0085). We only observed SBP had a marginal causal effect (0.05&lt;p&lt;0.1) among males aged 50-59 (&amp;#946;= -0.0458), females aged 40-49 (&amp;#946;= -0.0446) and aged 50-59 (&amp;#946;=0.0326). Conclusion: Hypertension and genetic predisposition to higher BP can accelerate WM brain aging specifically targeting at late middle-aged women, providing insights on planning effective control of BP for women in this age group.
Abstract 27: Genetic Risk of Blood Pressure on Antihypertensive Efficacy and Apparent Treatment Resistant Hypertension in Participants of the Genetics of Hypertension Associated Treatments (GenHAT) Study
Authors: Nicole D Armstrong, Vinodh Srinivasasainagendra, Vibhu Parcha, Akhil Pampana, Nita Limdi, Hemant K Tiwari, Donna K Arnett, Pankaj Arora, Marguerite M Irvin
Journal: Circulation (2023)

Background: Polygenic risk scores (PRS) have shown promise in complementing existing clinical risk factors and improving early diagnosis of cardiovascular disease. Recently, several studies have developed PRS for blood pressure traits; however, few have examined to what extent these PRS predict antihypertensive (AHT) efficacy. Hypothesis: We hypothesize that applying a systolic blood pressure (SBP) PRS developed and trained in multi-ancestral observational studies will predict response to chlorthalidone (CHL), as well as non-response to AHT treatment (apparent treatment resistant hypertension, aTRH), among African Americans (AA). Methods: We applied an optimized multi-ancestry PRS generated in a pooled Trans-Omics for Precision Medicine (TOPMed) cohort of &gt;21,000 adults for SBP (PRS SBP ) to 4,297 AA Genetics of Hypertension Associated Treatment (GenHAT) participants randomized to CHL as part of the Antihypertensive and Lipid Lowering Treatment to Prevent Heart Attack Trial (ALLHAT) with genome wide association study data. We then used linear regression to test the association of PRS SBP quintiles with CHL response (6 month BP - baseline BP) adjusting for age, sex, genetic ancestry, and baseline SBP. For the analysis of aTRH, cases were defined as individuals (a) treated with 3 different AHT classes, with average BP ≥140/90 mmHg at year 3 follow-up or (b) ≥4 AHT classes regardless of BP (cases, n=286). Treated controls were defined as individuals with BP &lt;140/90 mmHg and on trial drug monotherapy at year 3 (n=2,391). Logistic regression models adjusting for age, sex, and genetic ancestry were used to calculate the odds ratio for aTRH comparing the highest and lowest quintile (Q5 and Q1, respectively). Results: The PRS SBP was associated with reduced SBP response in Q5 (-5.01 [-6.15, -3.87] mmHg) versus Q1 (-8.24 [-9.39, -7.09] mmHg) and Q2 (-7.25 [-8.39, -6.11] mmHg). In regard to aTRH, Q5 was nominally associated with higher odds of aTRH compared to Q1 (1.48 [1.00, 2.20]). Conclusions: We found that a general SBP PRS was associated with BP response in AAs from GenHAT. On average, a greater SBP reduction was found in participants at low genetic risk (Q1 or Q2) compared to the high risk (Q5) taking the same AHT. Similarly, when compared to participants in the bottom 20% of the distribution, those in the top 20% had increased odds of aTRH. Additional work using the PRS SBP in other ancestral populations, as well as developing novel AHT class treatment response PRS, is warranted and in progress to determine whether we can identify individuals who would benefit the most from specific AHT classes.